Rare long-term care double win

James M. Berklan
James M. Berklan

So much for the dog days of summer getting close. Long-term care advocates were already at full woof on Tuesday — and that's a good thing.

If August slows down, as it almost always does in many places, especially Washington, D.C., so what?

The American Health Care Association and other long-term care providers will have July 28 to savor. Usually, there's plenty of bad news to fend off. This time, it was just the opposite.

First, take the NOTICE Act. It passed the Senate unanimously on Tuesday and was expected to be signed into law by the president. The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act (S. 1349) will require hospitals to notify Medicare beneficiaries of their outpatient status within 36 hours, or if sooner, upon discharge.

This will avert further shenanigans from hospitals that have abused the “observation stay” label. These doings have caused countless Medicare beneficiaries to face unexpectedly exorbitant bills for expensive care they thought was covered by Medicare — or to skimp on their long-term care altogether.

How united has the outcry against the hospitals' affront been? The House also passed the measure unanimouslyin March.

“Hospitals may act in the best interest of a patient's health but not always in the best interest of a patient's wallet,” pointed out Rep. Lloyd Doggett (D-TX), one of the bill's staunch supporters. “This new law arms patients with the knowledge they need to be their own best advocate.”

And that was just the first scoop of ice cream Tuesday. The other was AHCA leaders announcing that quality standards they developed with the National Association for the Support of Long Term Care were endorsed by the National Quality Forum.

“This is validation of our quality improvement efforts,” boasted AHCA President and CEO Mark Parkinson in a prepared statement. “Until now, there have been no uniform tools for providers to measure their progress on quality of life improvement for individuals receiving therapy.”

The measures align with what the Centers for Medicare & Medicaid Services is requiring the profession to implement through the IMPACT Act of 2014. Risk-adjusted outcome measures are based on the CARE Tool, and information from MDS assessments.

Thus far, AHCA leaders maintain, there have been no consistent measurements that show whether or not therapy patients discharged from an acute-care setting for rehabilitation have improved in functionality.

The CARE Improvement in Mobility and CARE Improvement in Self Care measures calculate the average change in mobility and self-care scores between admission and discharge for all residents admitted to a skilled nursing facility from a hospital or another post-acute care setting for therapy — regardless of payor status.

That means another one on the chin for hospitals, by the way. Unusual day, indeed.

What makes the special endorsement all the sweeter, AHCA leaders point out, is that NQF endorsement is secured only after extensive testing and evaluation of a measure's reliability and validity.

With Tuesday's victories in hand, it is now up to long-term care providers to prove they're worthy of them. AHCA's initiative, for example, calls for measurable improvement in no less than eight key areas by 2018. It's not as far away as it sounds.

James M. Berklan is McKnight's Editor. Follow him @JimBerklan.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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